The training-injury prevention paradox: should athletes be training smarter and harder?

The Connection Between Resistance Training, Climbing Performance, and Injury Prevention

BACKGROUND

Climbing is an intricate sport composed of various disciplines, holds, styles, distances between holds, and levels of difficulty. In highly skilled climbers the potential for further strength-specific adaptations to increase performance may be marginal in elite climbers. With an eye on the upcoming 2024 Paris Olympics, more climbers are trying to maximize performance and improve training strategies. The relationships between muscular strength and climbing performance, as well as the role of strength in injury prevention, remain to be fully elucidated. This narrative review seeks to discuss the current literature regarding the effect of resistance training in improving maximal strength, muscle hypertrophy, muscular power, and local muscular endurance on climbing performance, and as a strategy to prevent injuries.

MAIN BODY

Since sport climbing requires exerting forces against gravity to maintain grip and move the body along the route, it is generally accepted that a climber`s absolute and relative muscular strength are important for climbing performance. Performance characteristics of forearm flexor muscles (hang-time on ledge, force output, rate of force development, and oxidative capacity) discriminate between climbing performance level, climbing styles, and between climbers and non-climbers. Strength of the hand and wrist flexors, shoulders and upper limbs has gained much attention in the scientific literature, and it has been suggested that both general and specific strength training should be part of a climber`s training program. Furthermore, the ability to generate sub-maximal force in different work-rest ratios has proved useful, in examining finger flexor endurance capacity while trying to mimic real-world climbing demands. Importantly, fingers and shoulders are the most frequent injury locations in climbing. Due to the high mechanical stress and load on the finger flexors, fingerboard and campus board training should be limited in lower-graded climbers. Coaches should address, acknowledge, and screen for amenorrhea and disordered eating in climbers.

CONCLUSION

Structured low-volume high-resistance training, twice per week hanging from small ledges or a fingerboard, is a feasible approach for climbers. The current injury prevention training aims to increase the level of performance through building tolerance to performance-relevant load exposure and promoting this approach in the climbing field.

Ligament Injuries in Professional Male Handball Players: A 6-Year Longitudinal Study

Handball is a sport that involves high-intensity actions throughout the game, such as sprints, jumps, landings, and high-speed, repeated throws. This, along with competitive and tactical factors, congested schedules, and the need to maintain a high level of performance throughout the season, contributes to a high injury rate. This study aimed to analyse ligament injuries in a professional handball team over six consecutive seasons. A total of 68 elite male Spanish handball players participated, with 54 time-loss injuries (i.e., injuries involving at least one day of absence) observed during this study period. Ligament injury information was recorded following the International Olympic Committee consensus statement. The overall incidence was 0.89 ligament injuries per 1000 h of exposure. Additionally, a higher incidence and burden of ligament injuries was observed during match-play compared to training. Most ligament injuries were classified as minor or moderate (i.e., 79.63% of the total), and 46.29% were reinjuries. A significantly higher incidence of ligament injuries was suffered in the lower limbs compared to the upper limbs (0.81 vs. 0.08 ligament injuries per 1000 h; p < 0.001). Specifically, the highest incidence was observed in the anterior talofibular ligament of the ankle (0.57 injuries per 1000 h of exposure), while the greatest burden was related to the anterior cruciate ligament (24.08 absence days per 1000 h of exposure). This study provides an overview of ligament injuries among professional handball players, highlighting the need to implement strategies with positive effects during competition (e.g., specific activation strategies or training programmes based on strength and balance) and to reduce injury recurrences.

Unraveling the "golden ratio": a pilot study investigating acute-to-chronic workload ratio in breast cancer patients undergoing active treatment

Training load monitoring is a common practice in sports medicine for supporting athletes' health and performance. Despite progress in exercise oncology research for breast cancer patients, training load monitoring is underutilized. This study retrospectively investigated the relationship between maintained training load within a defined range and physical and health outcomes of ten breast cancer patients during active anticancer treatment who underwent a 12-week exercise program. Intervention consisted of endurance and resistance training, three times a week, with each session lasting 30-45 min. Assessments were conducted at baseline, 6 and 12 weeks after enrollment, evaluating physical function (6-min walk test-6MWT, and sit-to-stand), muscle strength, body composition, sleep quality (Pittsburgh Sleep Quality Index-Pittsburgh Sleep Quality Index), quality of life (EORTC-QLQ-C30), heart rate variability and physical activity levels (International Physical Activity Questionnaire-International Physical Activity Questionnaire). The Physiological Cost Index/Energy Expenditure Index (PCI/EEI) was estimated using the 6MWT and Heart rate. Training load monitoring was performed by session rating of perceived exertion (sRPE, relative intensity multiplying with session duration). Acute-to-Chronic Workload Ratio (ACWR) (7:28, rolling average) was calculated accordingly. Analyses were performed within-subjects across time points and between-subjects, comparing those who maintained from weeks 6-12 an ACWR of 0.8-1.3 with those who did not. Adherence rates were similar between groups. Physical function improved in the total sample with large effect sizes (Δ6MWT = 56.5 m [95%CI: 6-100 m], effect size [w] = 0.52, p = 0.006; ΔSit-to-Stand = 1.5 [95%CI: 1-5], effect size [w] = 0.681, p < 0.001), demonstrating greater changes in patients with higher ACWR. Sleep quality improvements were higher in the appropriate ACWR group (p = 0.016). A positive correlation was demonstrated between global health status and 6MWT change from baseline to 12 weeks (ρ = 0.689, p = 0.04). Despite a small sample size, patients maintaining sufficient relative training load presented greater physical fitness and sleep quality improvements. Thus, training load monitoring may enhance exercise program benefits in breast cancer patients under active treatment.

A moderated mediation analysis on the influence of social support and cognitive flexibility in predicting mental wellbeing in elite sport

The purpose of this study was to examine the mechanism by which social support influences mental wellbeing. Using the thriving through relationships model to provide a theoretical underpinning, cognitive flexibility was hypothesised as a mediator. Additionally, the research examined the consistency of this pathway between elite athletes, retired athletes, and non-athletes. Survey responses from a sample of 247 participants (n = 49 elite athletes, n = 61 retired athletes, n = 137 convenience sample; of which 127 (51.4%) were males were included in the analysis. Initial mediation analysis revealed a significant indirect pathway from social support to mental wellbeing through cognitive flexibility. Moderated mediation analysis revealed this pathway was significant for retired athletes and the convenience sample, but not for elite athletes. Results provide additional insight into the mechanisms by which social support influences wellbeing. Cognitive flexibility interventions may not be as effective for elite athletes.

Using wearable technology data to explain recreational running injury: A prospective longitudinal feasibility study

OBJECTIVES

Investigate 1) if collecting and analysing wristwatch inertial measurement unit (IMU) and global positioning system (GPS) data using a commercially-available training platform was feasible in recreational runners and 2) which variables were associated with subsequent injury.

DESIGN

Prospective longitudinal cohort.

PARTICIPANTS

Healthy recreational runners.

MAIN OUTCOME MEASURES

We set a priori feasibility thresholds for recruitment (maximum six-months), acceptance (minimum 80%), adherence (minimum 70%), and data collection (minimum 80%). Participants completed three patient-reported outcome measures (PROMS) detailing their psychological health, sleep quality, and intrinsic motivation to run. We extracted baseline anthropometric, biomechanical, metabolic, and training load data from their IMU/GPS wristwatch for analysis. Participants completed a weekly injury status surveillance questionnaire over the next 12-weeks. Feasibility outcomes were analysed descriptively and injured versus non-injured group differences with 95% confidence intervals were calculated for PROM/IMU/GPS data.

RESULTS

149 participants consented; 86 participants completed (55 men, 31 women); 21 developed an injury (0.46 injuries/1000km). Feasibility outcomes were satisfied (recruitment = 47 days; acceptance = 133/149 [89%]; adherence = 93/133 [70%]; data collection = 86/93 [92%]). Acute load by calculated effort was associated with subsequent injury (mean difference -562.14, 95% CI -1019.42, -21.53).

CONCLUSION

Collecting and analysing wristwatch IMU/GPS data using a commercially-available training platform was feasible in recreational runners.

Manipulating Internal and External Loads During Repeated Cycling Sprints: A Comparison of Continuous and Intermittent Blood Flow Restriction

ABSTRACT

Mckee, JR, Girard, O, Peiffer, JJ, and Scott, BR. Manipulating internal and external loads during repeated cycling sprints: A comparison of continuous and intermittent blood flow restriction. J Strength Cond Res 38(1): 47-54, 2024-This study examined the impact of blood flow restriction (BFR) application method (continuous vs. intermittent) during repeated-sprint exercise (RSE) on performance, physiological, and perceptual responses. Twelve adult male semi-professional Australian football players completed 4 RSE sessions (3 × [5 × 5-second maximal sprints:25-second passive recovery], 3-minute rest between the sets) with BFR applied continuously (C-BFR; excluding interset rest periods), intermittently during only sprints (I-BFR WORK ), or intraset rest periods (I-BFR REST ) or not at all (Non-BFR). An alpha level of p < 0.05 was used to determine significance. Mean power output was greater for Non-BFR (  p < 0.001, dz = 1.58 ), I-BFR WORK (  p = 0.002, dz = 0.63 ), and I-BFR REST (  p = 0.003, dz = 0.69 ) than for C-BFR and for Non-BFR (  p = 0.043, dz = 0.55 ) compared with I-BFR REST . Blood lactate concentration (  p = 0.166) did not differ between the conditions. Mean oxygen consumption was higher during Non-BFR (  p < 0.001, dz = 1.29 and 2.31; respectively) and I-BFR WORK ( p < 0.001, dz = 0.74 and 1.63; respectively) than during I-BFR REST and C-BFR and for I-BFR REST (  p = 0.002, dz = 0.57) compared with C-BFR. Ratings of perceived exertion were greater for I-BFR REST (  p = 0.042, dz = 0.51) and C-BFR (  p = 0.011, dz = 0.90) than for Non-BFR and during C-BFR (  p = 0.023, dz = 0.54) compared with I-BFR WORK . Applying C-BFR or I-BFR REST reduced mechanical output and cardiorespiratory demands of RSE and were perceived as more difficult. Practitioners should be aware that BFR application method influences internal and external demands during RSE.

Quantification of daily workload, energy expenditure, and sleep of US Marine recruits throughout a 10-week boot camp

BACKGROUND

During periods of high-volume vigorous exercise, United States Marine Corps recruits often experience musculoskeletal injuries. While the program of instruction (POI) for basic training is a defined training volume, the total workload of boot camp, including movements around the base, is unknown.

OBJECTIVE

The present study aimed to quantify the daily total workload, energy expenditure, and sleep during basic recruit training at Marine Corps Recruit Depot (MCRD) San Diego.

METHODS

Eighty-four male recruits from MCRD San Diego wore wrist wearable physiological monitors to capture their complete workload (mileage from steps), energy expenditure, and sleep throughout the 10-week boot camp.

RESULTS

Marine recruits traveled an average of 11.5±3.4 miles per day (M±SD), expended 4105±823 kcal per day, and slept an average of 5 : 48±1 : 06 hours and minutes per night. While the POI designates a total of 46.3 miles of running and hiking, the actual daily average miles yielded approximately 657.6±107.2 miles over the 10-week boot camp.

CONCLUSION

Recruit training requires high physical demand and time under tension due to the cumulative volume of movements around base in addition to the POI planned physical training.

Reduced Match Exposure in the Previous 2 Matches Accounts for Hamstring Muscle Injury Incidence in Professional Football Players

BACKGROUND

Hamstring strain injuries are one of the most prevalent injuries in football (soccer). We examined the influence of accumulated match-play exposure on the occurrence of hamstring strain injury in professional football from 2 teams (Spanish 1st Division, LaLiga) over 3 seasons, and determined specific cut-off points as indicators of injury risk.

HYPOTHESIS

Overloaded players would be more likely to sustain a hamstring injury.

STUDY DESIGN

Prospective, controlled, observational study.

LEVEL OF EVIDENCE

Level 2b.

METHODS

Playing time, total running distance, and high-speed running (>24 km/h) distance during official matches of players that sustained a hamstring injury were compared with uninjured, paired controls. Cumulative playing time and running performance of 4 matches before the injury was computed. Relative risk (RR) of injury occurrence was estimated by generalized estimating equations. Diagnostic accuracy was determined by receiver operating characteristics and the area under the curve.

RESULTS

Thirty-seven hamstring strain injuries occurred, representing 23 ± 18 absence days per injury. Thirty-seven controls (uninjured players) were used as comparators. Low match-play exposures during 1 and 2 matches before injury were likely to explain injury occurrence (RR: 14-53%; P < 0.01). Metrics from the match before the hamstring muscle strain demonstrated the best accuracy to predict injury occurrence: high-speed running distance ≤328 m (sensitivity, 64%; specificity, 84%), playing time ≤64 min (sensitivity, 36%; specificity, 97%), and running distance ≤5.8 km (sensitivity, 39%; specificity, 97%).

CONCLUSION

Relatively reduced competitive exposure in the previous 2 matches was associated with higher hamstring injury risk in professional football players.

CLINICAL RELEVANCE

Screening simple metrics such as the accumulated match exposure during official matches and considering specific cut-off points for some running variables may be good indicators of injury risk and may assist in better individual injury management in professional soccer players.

Overuse Injuries, Overtraining, and Burnout in Young Athletes

Sports participation can have tremendous physical and mental health benefits for children. Properly implemented progressive training programs can yield a broad range of beneficial physiologic adaptations, but imbalances of training load and recovery can have important negative consequences. Overuse injuries, for example, can result from repetitive stress without sufficient recovery that leads to accumulated musculoskeletal damage. In addition, extended periods of increased training loads that exceed the intervening recovery can have systemic consequences such as overtraining syndrome, which results in decreased performance, increased injury and illness risk, and derangement of endocrine, neurologic, cardiovascular, and psychological systems. Burnout represents one of the primary reasons for attrition in youth sports. Broadly defined as physical or mental exhaustion and a reduced sense of accomplishment that leads to devaluation of sport, burnout represents a direct threat to the goal of lifelong physical activity and the wide-ranging health benefits that it provides. This clinical report is intended to provide pediatricians with information regarding the risk factors, diagnosis, management, and prevention of these conditions to assist in the identification of at-risk children, the treatment of young athletes, and the guidance of families in the promotion of safe and healthy sport participation.

Weekly Training Load Differences between Starting and Non-Starting Soccer Players

The aim of this study was to examine the differences in the weekly training load between starters and non-starters classified based on the match starting line-up, with respect to the playing position and a training day. Notably, 31 young adult soccer players (age: 18.79 ± 1.04 years) competing in the 3rd Czech division were monitored across the season. The weekly training load was measured using a GPS system as follows: total distance covered (TD), high-speed running distance (HSR), sprint running distance (SR), and acceleration and deceleration distance (ACDC). We found higher values in three out of four observed variables (HSR, SR, and ACDC, excluding TD) for starters compared to non-starters (p < 0.05), with small to moderate effect sizes (d = 0.40-0.49). Differences were observed especially in players who were fullbacks, offensive midfielders, and forwards. Moreover, the largest differences were found in training prior to a match day for HSR, SR, and ACDC (p < 0.05). Non-starters experienced lower weekly external loads in offensive player positions, predominantly in high-intensity variables, which are essential for their physical performance. It seems that non-starters may experience potential under-loading in the training process. Coaches and practitioners should be aware of this potential risk and find an appropriate method to compensate for load discrepancies, particularly in terms of high-intensity activities.

A new statistical approach to training load and injury risk: separating the acute from the chronic load

The relationship between recent (acute) training load relative to long-term (chronic) training load may be associated with sports injury risk. We explored the potential for modelling acute and chronic loads separately to address current statistical methodology limitations. We also determined whether there was any evidence of an interaction in the association between acute and chronic training loads and injury risk in football. A men's Qatar Stars League football cohort (1 465 players, 1 977 injuries), where training load was defined as the number of minutes of activity, and a Norwegian elite U-19 football cohort (81 players, 60 injuries), where training load was defined as the session rating of perceived exertion (sRPE). Mixed logistic regression was run with training load on the current day (acute load) and cumulative past training load estimated by distributed lag non-linear models (chronic load) as independent variables. Injury was the outcome. An interaction between acute and chronic training load was modelled. In both football populations, we observed that the risk of injury on the current day for different values of acute training load was highest for players with low chronic load, followed by high and then medium chronic load. The slopes varied substantially between different levels of chronic training load, indicating an interaction. Modelling acute and chronic loads separately in regression models is a suitable statistical approach for analysing the association between relative training load and injury risk in injury prevention research. Sports scientists should also consider the potential for interactions between acute and chronic load.

Female Athletes and the Menstrual Cycle in Team Sports: Current State of Play and Considerations for Future Research

Over the past ten years there has been a dramatic rise in female sport participation and accompanying female professional national leagues across multiple sports, yet research has not followed suit. Although there are known variations between female and male physiology, training protocols in female sport are predominantly underpinned by research undertaken in male athletes. The hormonal variability experienced by women across the menstrual cycle, as well as the menstrual cycle variability between women, may contribute to the complexity of conducting rigorous physiological studies, leading to a paucity of robust sports-specific research that can be confidently applied to female athletes. Moreover, barriers exist in female sport that potentially limit the ability to conduct research, including the lack of full-time programs and limited resources. Recently, there has been increased interest in the potential effects of fluctuations in the female sex hormones, progesterone and oestrogen, on sport performance across different phases of the menstrual cycle. However, current research evaluating the menstrual cycle and physical performance (such as strength, speed, aerobic fitness, and athletes' perception of their performance) have shown inconsistent results. Additionally, methodological design across studies has shown little consistency, making it difficult to draw firm conclusions, which potentially prevents female athletes optimising their physical and sporting performance. It further impacts coaches and sports science researchers in their ability to provide appropriate training recommendations and educational opportunities. It is important to progress in female athlete research with an understanding of how the unique physiology of female athletes may influence their ability to physically perform in their respective sport, which requires representation in sports science research. This paper will provide an overview on current evidence and limitations within menstrual cycle research and provide considerations and directions for future research in this space within team sports.

Is a Maximal Strength-Training Program Effective on Physical Fitness, Injury Incidence, and Injury Burden in Semi-Professional Soccer Players? A Randomized Controlled Trial

The aims of the study were to analyze the effects of a 12-week maximal strength- training program on injury incidence, injury burden, and physical fitness in semi-professional soccer players and to compare the perceived exertion load and well-being state between injured and non-injured soccer players. Twenty semi-professional male soccer players participated in this study. Participants were randomly allocated to an experimental group (EG, n = 10 players), who performed a maximal strength-training program, or to a control group (CG, n = 10 players), who only performed their regular soccer training. Physical fitness was measured at baseline and after the training program. In addition, the injury incidence, burden, training/match load, and the state of well-being of the players were recorded. The EG showed significant improvements in vertical jumps, change in direction ability, linear sprints, repeated sprint ability, isometric strength (p < 0.003; effect size = 1.78-11.86), and quadriceps-hamstring imbalance in both legs (p < 0.001; effect size = 2.37-3.71) in comparison to the CG. In addition, the EG players showed a significantly (p < 0.05) lower injury burden (p < 0.001, relative risk = 5.05, 95% confidence interval = 3.27-7.79). This study demonstrated the beneficial effects of a 12-week maximal strength-training program on physical fitness attributes and injury burden in semi-professional soccer players.

A novel approach for sports injury risk prediction: based on time-series image encoding and deep learning

The rapid development of big data technology and artificial intelligence has provided a new perspective on sports injury prevention. Although data-driven algorithms have achieved some valuable results in the field of sports injury risk assessment, the lack of sufficient generalization of models and the inability to automate feature extraction have made it challenging to deploy research results in the real world. Therefore, this study attempts to build an injury risk prediction model using a combination of time-series image encoding and deep learning algorithms to address this issue better. This study used the time-series image encoding approach for feature construction to represent relationships between values at different moments, including Gramian Angular Summation Field (GASF), Gramian Angular Difference Field (GADF), Markov Transition Field (MTF), and Recurrence Plot (RP). Deep Convolutional Auto-Encoder (DCAE) learned the image-encoded data for representation to obtain features with good discrimination, and the classifier was performed using Deep Neural Network (DNN). The results from five repeated experiments show that the GASF-DCAE-DNN model is overall better in the training (AUC: 0.985 ± 0.001, Gmean: 0.930 ± 0.007, Sensitivity: 0.997 ± 0.003, Specificity: 0.868 ± 0.013) and test sets (AUC: 0.891 ± 0.026, Gmean: 0.830 ± 0.027, Sensitivity: 0.816 ± 0.039, Specificity: 0.845 ± 0.022), with good discriminative power, robustness, and generalization ability. Compared with the best model reported in the literature, the AUC, Gmean, Sensitivity, and Specificity of the GASF-DCAE-DNN model were higher by 23.9%, 27.5%, 39.7%, and 16.2%, respectively, which confirmed the validity and practicability of the model in injury risk prediction. In addition, differences in injury risk patterns between the training and test sets were identified through shapley additivity interpretation. It was also found that the training volume was an essential factor that affected injury risk prediction. The model proposed in this study provides a powerful injury risk prediction tool for future sports injury prevention practice.

Monitoring load, wellness, and psychological variables in female and male youth national team football players during international and domestic playing periods

Aim

To study differences in total load exposure, wellness, and psychological variables in youth female (N = 19) and male (N = 20) national team football players during domestic and international playing periods, respectively.

Procedures

The players filled out questionnaires on well-being, stress, and resilience before and after both playing periods lasting 8 days each. The Hooper index was used to monitor daily wellness levels during both playing periods. The number of training sessions and matches were recorded, and the session rating of perceived exertion was collected. Training load, monotony, and strain were calculated. Daily measurements were used to evaluate in-period changes, and composite scores were used to describe differences between periods.

Results

The international compared to the domestic playing period was for both groups characterized by more matches played, longer field training session durations, and of fewer gym-based sessions (P < 0.05). The male players increased total exposure time (25%; P < 0.05), monotony (P < 0.001), and strain (P < 0.001), which was not changed in the female players. Well-being decreased (P < 0.05) during the international playing period in male players. Stress levels were higher (P < 0.05) for both genders during the international compared to the domestic playing period. During the international playing period, positive correlations were found between the initial levels of stress, and the change in stress (P = 0.03; r2 = 0.12), and between the changes in total load and changes in well-being (P = 0.02; r2 = 0.12), whereas a negative correlation was found between the changes in wellness and stress (P = 0.03; r2 = 0.14).

Conclusion

A playing period characterized by increased match focus, longer field training sessions, and fewer gym-based training activities may lead to changes in the physical and mental profiles of youth national team football players. Alterations to load exposure and wellness may influence mental health. Players with high initial stress levels may be subjected to greater changes compared to other players. Sports scientists and medical staff may benefit from initiating structured monitoring systems to track alterations in physical load and mental health in youth national team players.

Risk factors and injury prevention strategies for overuse injuries in adult climbers: a systematic review

Introduction

Climbing is an increasingly popular activity and imposes specific physiological demands on the human body, which results in unique injury presentations. Of particular concern are overuse injuries (non-traumatic injuries). These injuries tend to present in the upper body and might be preventable with adequate knowledge of risk factors which could inform about injury prevention strategies. Research in this area has recently emerged but has yet to be synthesized comprehensively. Therefore, the aim of this study was to conduct a systematic review of the potential risk factors and injury prevention strategies for overuse injuries in adult climbers.

Methods

This systematic review was conducted in accordance with the PRISMA guidelines. Databases were searched systematically, and articles were deemed eligible based upon specific criteria. Research included was original and peer-reviewed, involving climbers, and published in English, German or Czech. Outcomes included overuse injury, and at least one or more variable indicating potential risk factors or injury prevention strategies. The methodological quality of the included studies was assessed with the Downs and Black Quality Index. Data were extracted from included studies and reported descriptively for population, climbing sport type, study design, injury definition and incidence/prevalence, risk factors, and injury prevention strategies.

Results

Out of 1,183 records, a total of 34 studies were included in the final analysis. Higher climbing intensity, bouldering, reduced grip/finger strength, use of a "crimp" grip, and previous injury were associated with an increased risk of overuse injury. Additionally, a strength training intervention prevented shoulder and elbow injuries. BMI/body weight, warm up/cool downs, stretching, taping and hydration were not associated with risk of overuse injury. The evidence for the risk factors of training volume, age/years of climbing experience, and sex was conflicting.

Discussion

This review presents several risk factors which appear to increase the risk of overuse injury in climbers. Strength and conditioning, load management, and climbing technique could be targeted in injury prevention programs, to enhance the health and wellbeing of climbing athletes. Further research is required to investigate the conflicting findings reported across included studies, and to investigate the effectiveness of injury prevention programs.

Systematic Review Registration

https://www.crd.york.ac.uk/, PROSPERO (CRD42023404031).

A Finger in the Game: Sport-Specific Finger Strength Training and Onset of Injury

INTRODUCTION

Strength training has proved to be an effective way to prevent injuries, but the evidence of the impact of strength training on finger injuries is lacking. A fingerboard is a sport-specific tool used by climbers for strength training of fingers. In this study, we searched for associations between fingerboard training and finger injuries in climbers with different lengths of climbing experience and levels of performance.

METHODS

A web-based survey was used to collect information on self-perceived pain or injury in fingers (SPIIF) and regular fingerboard training (RFT). The survey was administered to the Finnish climbing community. Data were analyzed using contingency tables; chi-square was used to evaluate statistical significance.

RESULTS

No significant correlations between SPIIF and RFT were found when analyzing all the participants (n=434) together. In climbers with 6 y or more in the sport, SPIIF was not common and RFT was negatively associated with SPIIF (χ2 [1, n=200]=4.57; P=0.03). In contrast to this, in male climbers who had been climbing for less than 6 y and had advanced to 7a level or higher (French lead/Font bouldering), SPIIF was common and RFT was positively associated with SPIIF (χ2 [1, n=75]=4.61; P=0.03).

CONCLUSIONS

We suggest that doing RFT may prevent SPIIF in climbers with a long background in the sport as fingerboard training can help build stronger fingers and thereby stronger tendons and ligaments. Climbers with fewer years in the sport and less adaptation to the fingers should be cautious with their training loads and RFT to avoid finger injuries and pain.

Female Soccer Periodization on Anaerobic Power/Capacity

ABSTRACT

Purdom, TM, Levers, KS, Ryan, GA, Brown, L, Giles, J, and McPherson, C. Female soccer periodization on anaerobic power/capacity. J Strength Cond Res 37(12): 2405-2410, 2023-The purpose of this study was to observe changes in anaerobic power and capacity (resistance to fatigue) over an annual training cycle (ATC) in 14 Division I female soccer athletes (19.4 ± 1.0 years, 60.8 ± 5.4 kg, 164.9 ± 6.2 cm, 19.5 ± 3.2% body fat, and 48.9 ± 3.9 kg fat free mass). All subjects were evaluated across the ATC at 5 testing blocks (B1-B5) representing seasonal transitions: postcompetition I (B1), prespring (B2), postspring training (B3), precompetition (B4), and postcompetition II (B5) using 3 tests: countermovement vertical jump to measure peak vertical power (PVP), 40-yard sprint to measure peak horizontal power (PHP), and 35-m running anaerobic sprint test to measure anaerobic capacity via fatigue index (FI). Repeated measures analysis of variance was used with the Bonferroni post hoc test when relevant along with Cohen's d to evaluate effect size. Data are represented as mean ± SD ; significance set to p < 0.05. Significant performance increases were observed from postseason I to spring season training (B1-B3) in PVP (6.61 ± 3.18 and 7.71 ± 3.20; p < 0.01, d = 1.12) while changes occurred from prespring season to postspring season (B2-B3) in PVP (6.84 ± 3.15 and 7.71 ± 3.20; p = 0.03, d = 0.93) and PHP (6.65 ± 0.97 and 7.55 ± 1.26; p < 0.01, d = 1.06) with no change in body composition. No other significant changes were observed across the ATC ( p > 0.05). Increases in PHP and PVP occurred with directed training after B3 and then declined remaining so across the competitive season. Peak horizontal power and PVP may be more sensitive to coaching style and seasonal transition compared with FI and body composition changes.

Managing Lower Limb Muscle Reinjuries in Athletes: From Risk Factors to Return-to-Play Strategies

Muscle injuries and subsequent reinjuries significantly impact athletes, especially in football. These injuries lead to time loss, performance impairment, and long-term health concerns. This review aims to provide a comprehensive overview of the current understanding of muscle reinjuries, delving into their epidemiology, risk factors, clinical management, and prevention strategies. Despite advancements in rehabilitation programs and return-to-play criteria, reinjury rates remain alarmingly high. Age and previous muscle injuries are nonmodifiable risk factors contributing to a high reinjury rate. Clinical management, which involves accurate diagnosis, individualized rehabilitation plans, and the establishment of return-to-training and return-to-play criteria, plays a pivotal role during the sports season. Eccentric exercises, optimal loading, and training load monitoring are key elements in preventing reinjuries. The potential of artificial intelligence (AI) in predicting and preventing reinjuries offers a promising avenue, emphasizing the need for a multidisciplinary approach to managing these injuries. While current strategies offer some mitigation, there is a pressing need for innovative solutions, possibly leveraging AI, to reduce the incidence of muscle reinjuries in football players. Future research should focus on this direction, aiming to enhance athletes' well-being and performance.

Analysis of Accumulated Workloads and Performance Testing Across a Collegiate Women's Lacrosse Season

ABSTRACT

Fields, JB, Kuhlman, NM, Jagim, AR, Dulak-Sigler, C, and Jones, MT. Analysis of accumulated workloads and performance testing across a collegiate women's lacrosse season. J Strength Cond Res 37(11): 2213-2221, 2023-Monitoring accumulated workloads, acute:chronic workload ratios (ACWR), and training monotony (TM) are practical methods for monitoring athlete physical stress. Performance testing provides useful information about the changing nature of physical abilities. Therefore, the purpose was to examine differences in accumulated workloads based on session type, explore seasonal trends in ACWR and TM, and assess changes in performance assessments in collegiate women's lacrosse athletes. Athletes, who were identified as starters ( n = 12), wore positional monitoring technology during training sessions ( n = 61) and games ( n = 17) and completed preseason and postseason assessments of speed, agility, power (jump tests), strength, aerobic capacity, and body composition. Separate 1-way analyses of variance were used to determine differences in accumulated workloads for session type and differences in performance assessments from preseason to postseason ( p < 0.05). When compared with games, practice sessions elicited greater ( p < 0.001) accumulated total distance, player load, repeated high-intensity efforts, accelerations, change of direction, explosive efforts, high-speed efforts ( p = 0.002), and high-speed distance ( p = 0.002). Throughout the season, ACWR and TM ranged from 0.16 to 1.40 AU and 0.68-1.69 AU, respectively. The 40-yd sprint ( p < 0.001) and pro-agility ( p < 0.001) improved from preseason to postseason, whereas no changes in aerobic capacity, lower-body power, or strength were observed ( p > 0.05). The monitoring of accumulated loads, ACWR and TM, and performance tests revealed novel information about the seasonal demands of collegiate women's lacrosse. Women lacrosse players are able to improve speed and agility throughout the season, while maintaining strength, power, and endurance, with minimal reductions in fat-free mass.

Effect of Different Nonstarter Compensatory Strategies on Training Load in Female Soccer Players: A Pilot Study

BACKGROUND

In soccer, the day of the week with the highest external load is match day (MD), with starters (>60 minutes per match) showing higher levels of physical fitness and seasonal high-intensity loading. It is necessary, therefore, to determine training strategies to reduce the differences between starters and nonstarters. The aim of this study was to analyze and compare the external load of different training compensatory strategies with match external load in female nonstarters.

HYPOTHESIS

A strategy combining small-sided games (SSG) and running-based drills (RBD) would reproduce match demands, with RBD leading to greater high-intensity running and SSG leading to a greater number of accelerations and decelerations.

STUDY DESIGN

Descriptive and comparative study.

LEVEL OF EVIDENCE

Level 4.

METHODS

The training and match external load of 14 female players belonging to the same reserve squad of a Spanish First Division Club (Liga Reto Iberdrola) was registered. In the first session after the match (MD+1), nonstarters (<60 minutes in the match) performed 1 of 3 different compensatory strategies: RBD, SSG, or a mixed intervention combining the previous strategies (RBD+SSG). Starters carried out a recovery session.

RESULTS

A marked difference in load was observed between the compensatory training strategies and MD. In comparison with MD, RBD showed greater high-intensity and sprint distances and lower acceleration, SSG showed less high-intensity running and sprint distances, lower peak velocity, and greater acceleration, and RBD+SSG registered lower accelerations. In addition, nonstarters covered greater high-intensity running and sprint distances in RBD and achieved higher accelerations in SSG.

CONCLUSION

RBD and SSG compensatory strategies could be recommended to nonstarter female soccer players in MD+1 to compensate for match external load deficits.

CLINICAL RELEVANCE

This study provides comprehensive information on the compensatory exercises of female soccer players, which can be useful for strength and conditioning coaches when developing recovery strategies during a microcycle.

Epidemiology of musculoskeletal injury in military recruits: a systematic review and meta-analysis

BACKGROUND

Injuries are a common occurrence in military recruit training, however due to differences in the capture of training exposure, injury incidence rates are rarely reported. Our aim was to determine the musculoskeletal injury epidemiology of military recruits, including a standardised injury incidence rate.

METHODS

Epidemiological systematic review following the PRISMA 2020 guidelines. Five online databases were searched from database inception to 5th May 2021. Prospective and retrospective studies that reported data on musculoskeletal injuries sustained by military recruits after the year 2000 were included. We reported on the frequency, prevalence and injury incidence rate. Incidence rate per 1000 training days (Exact 95% CI) was calculated using meta-analysis to allow comparisons between studies. Observed heterogeneity (e.g., training duration) precluded pooling of results across countries. The Joanna Briggs Institute Quality Assessment Checklist for Prevalence Studies assessed study quality.

RESULTS

This review identified 41 studies comprising 451,782 recruits. Most studies (n = 26; 63%) reported the number of injured recruits, and the majority of studies (n = 27; 66%) reported the number of injuries to recruits. The prevalence of recruits with medical attention injuries or time-loss injuries was 22.8% and 31.4%, respectively. Meta-analysis revealed the injury incidence rate for recruits with a medical attention injury may be as high as 19.52 injuries per 1000 training days; and time-loss injury may be as high as 3.97 injuries per 1000 training days. Longer recruit training programs were associated with a reduced injury incidence rate (p = 0.003). The overall certainty of the evidence was low per a modified GRADE approach.

CONCLUSION

This systematic review with meta-analysis highlights a high musculoskeletal injury prevalence and injury incidence rate within military recruits undergoing basic training with minimal improvement observed over the past 20 years. Longer training program, which may decrease the degree of overload experienced by recruit, may reduce injury incidence rates. Unfortunately, reporting standards and reporting consistency remain a barrier to generalisability.

TRIAL REGISTRATION

PROSPERO (Registration number: CRD42021251080).

Neuromechanics of finger hangs with arm lock-offs: analyzing joint moments and muscle activations to improve practice guidelines for climbing

Introduction

Climbing imposes substantial demands on the upper limbs and understanding the mechanical loads experienced by the joints during climbing movements is crucial for injury prevention and optimizing training protocols. This study aimed to quantify and compare upper limb joint loads and muscle activations during isometric finger hanging exercises with different arm lock-off positions.

Methods

Seventeen recreational climbers performed six finger dead hangs with arm lock-offs at 90° and 135° of elbow flexion, as well as arms fully extended. Upper limb joint moments were calculated using personalized models in OpenSim, based on three-dimensional motion capture data and forces measured on an instrumented hang board. Muscle activations of upper limb muscles were recorded with surface electromyography electrodes.

Results

Results revealed that the shoulder exhibited higher flexion moments during arm lock-offs at 90° compared to full extension (p = 0.006). The adduction moment was higher at 135° and 90° compared to full extension (p < 0.001), as well as the rotation moments (p < 0.001). The elbows exhibited increasing flexion moments with the increase in the arm lock-off angle (p < 0.001). Muscle activations varied across conditions for biceps brachii (p < 0.001), trapezius (p < 0.001), and latissimus dorsi, except for the finger flexors (p = 0.15).

Discussion

Our findings indicate that isometric finger dead hangs with arms fully extended are effective for training forearm force capacities while minimizing stress on the elbow and shoulder joints. These findings have important implications for injury prevention and optimizing training strategies in climbing.

Are non-starters accumulating enough load compared with starters? Examining load, wellness, and training/match ratios of a European professional soccer team

BACKGROUND

The aims of the study were to: (i) compare accumulated load and wellness between starters and non-starters of a European professional soccer team; (ii) analyze the relationships between wellness and load measures and; (iii) compare training/match ratio (TMr) of external and internal load between starters and non-starters.

METHODS

Ten players were considered starters while seven were classified as non-starters over a 16-week period in which six training sessions and match day (MD) were considered in each weekly micro-cycle. The following measures were used: wellness (fatigue, quality of sleep, muscle soreness, stress, and mood); load (rated of perceived exertion (RPE), session-RPE (s-RPE), high-speed running (HSR), sprinting, accelerations (ACC) and decelerations (DEC)). Accumulated wellness/load were calculated by summing all training and match sessions, while TMr was calculated by dividing accumulated training load by match data for all load measures and each player. Mann-Whitney U test was used for wellness variables, while independent T-test was used for the remaining variables to compare groups. Moreover, relationships among variables were explored using the Spearman's Rho correlation coefficient.

RESULTS

The main results showed that non-starters presented higher significant values for fatigue (p < 0.019; g = 0.24) and lower significant values for duration (p < 0.006; ES = 1.81) and s-RPE (p < 0.001; ES = 2.69) when compared to starters. Moreover, positive and very large correlation was found between quality of sleep and RPE, while negative and very large correlation were found between stress and deceleration, and mood and deceleration (all, p < 0.05). Finally, non-starters presented higher values in all TMr than starters, namely, RPE (p = 0.001; g = 1.96), s-RPE (p = 0.002; g = 1.77), HSR (p = 0.001; g = 2.02), sprinting (p = 0.002; g = 4.23), accelerations (p = 0.001; g = 2.72), decelerations (p < 0.001; g = 3.44), and duration (p = 0.003; g = 2.27).

CONCLUSIONS

In conclusion, this study showed that non-starters produced higher TMr in all examined variables despite the lower match and training durations when compared with starters, suggesting that physical load was adjusted appropriately. Additionally, higher RPE was associated with improved sleep while higher number of decelerations were associated with decreased wellness, namely, stress and mood for non-starters.

Injury incidence in male elite youth football players is associated with preceding levels and changes in training load

Objectives

Elite youth football players miss out on a large part of seasonal training due to injury. Limited research suggests an association between external and internal training load (TL) and injury incidence in elite youth football. This study analysed external and internal TL variables and their association with injury incidence in a group of male elite youth football players over four seasons.

Methods

Measures of external and internal TL and injury incidence of 56 male elite youth football players (age 17-19 years) were collected throughout four seasons. Heart rate, session rating of perceived exertion andGlobal Positioning System (GPS) variables were analysed. Individual players' TL during the 30 days leading up to injury was compared with 30-day injury-free control periods. Change in TL through the periods was also analysed.

Results

Eighty-five injuries were included for analysis, showing that for most TL variables, the average levels were significantly lower during the period leading up to injury. Significant increases for the majority of TL variables were also found during the periods leading up to injury, while the control periods did not show any significant change.

Conclusion

A lower and/or increasing average TL volume over 30 days might increase the risk of injury in male elite youth football players. Avoiding long-term drops in TL and balance increases in TL might be beneficial to reduce injury risk.

Epidemiology of injuries in young volleyball athletes: a systematic review

BACKGROUND

Volleyball is among the five most popular sports in the world. Regardless of level and age, volleyball athletes perform fast high-impact movements such as jumps, landings, and changes in direction, demanding motor and sensory skills to avoid injuries. The available scientific literature provides information regarding the incidence of injuries in volleyball, but the evidence of injuries in young volleyball athletes (12-18 years old) is not well defined. Therefore, a systematic review was conducted to investigate the incidence and prevalence of injuries in young volleyball players.

METHODS

This systematic review was conducted according to the PRISMA recommendations and prospectively registered in PROSPERO (ID: CRD42022344623). An electronic search was conducted in the following databases: Web of Science, PubMed, and SportDiscuss via EBSCO in August 2022 and March 2023. Inclusion criteria followed the PICOS acronym: (P) youth volleyball players; (I) volleyball; (C) none; (O) incidence and/or prevalence of injury; and (S) cohort studies. The risk of bias was analysed using the adapted STROBE instrument.

RESULTS

Five studies were included in the qualitative analysis. They had a mean methodological quality of 6 (range 4-8) on the modified STROBE scale. Injury incidence was presented in varying ways, ranging from 1.51 injuries/1000 player hours to 12.4 injuries/10,000 athlete exposures (AEs). The prevalence was 1.6 ± 1.7 per 100 AEs. A total sample of 3698 youth volleyball athletes predominantly females was found. The body sites with the highest rate of injuries were the ankle, the distal portion of the upper limbs (wrist/hand/fingers) and the knee, respectively.

CONCLUSION

There was remarkable variability in the rate of injuries and the form of presentation between the studies. In addition, junior volleyball athletes had lower injury rates compared to other sports practised in high school, and older athletes had higher injury rates.

Internal workload in elite female football players during the whole in-season: starters vs non-starters

The aim of this study was to quantify weekly internal workload across the in-season and compare the workload variables between starter and non-starter Spanish female first league (Liga Iberdrola) football players. Twenty-six participants belonging to the same team (age, height, and mass: 25.4 ± 6.1 years, 167.4 ± 4.8 cm and 57.96 ± 6.28 kg, respectively) participated in this study. Training loads (TL) and match loads (ML) were assessed through breath-cardiovascular (RPEbreath), leg-musculature (RPEleg) and cognitive (RPEcog) rating of perceived exertion (RPE0-10) for each training session and match during the in-season phase (35 weeks). Session-RPE (sRPE) was calculated by multiplying each RPE value by session duration (minutes). From these, total weekly TL (weekly TL+ML), weekly TL, weekly ML, chronic workload, acute:chronic workload ratio, training monotony, and training strain were calculated. Linear mixed models were used to assess differences for each dependent variable, with playing time (starter vs non-starter players) used as a fixed factor, and athlete, week, and team as random factors. The results showed that total weekly TL (d = 1.23-2.04), weekly ML (d = 4.65-5.31), training monotony (d = 0.48-1.66) and training strain (d = 0.24-1.82) for RPEbreath, RPEleg and RPEcog were higher for starters in comparison with non-starters (p = 0.01). Coaches involved in elite female football should consider implementing differential sRPE monitoring strategies to optimize the weekly load distribution for starters and non-starters and to introduce compensatory strategies to equalise players' total weekly load.

A multicomponent neuromuscular warm-up program reduces lower-extremity injuries in trained basketball players: a cluster randomized controlled trial

OBJECTIVE

To assess the effects of a novel multicomponent neuromuscular warm-up program on lower-extremity injury incidence in basketball players competing at the regional level.

METHODS

A cluster randomized controlled experimental design was adopted to compare injury incidence between players exposed to the injury prevention warm-up program and those exposed to a typical warm-up program across an entire basketball season. Four teams consisting of 57 players (male: n = 42; female: n = 15) were allocated to the intervention group (age: 21.6 ± 2.5 years; height: 186.2 ± 8.8 cm; body mass: 80.0 ± 10.4 kg) and four teams consisting of 55 players (male: n = 43; female: n = 12) were allocated to the control group (age: 21.6 ± 2.6 years; height: 186.9 ± 9.1 cm; body mass: 81.5 ± 10.9 kg). The novel warm-up combined running exercises with active stretching, plyometrics, balance, strength, and agility drills. Coaching and medical staff provided details on injury incidence each week. Data analyses included the use of poisson regression analyses and the incidence rate ratio (IRR) with 95% confidence intervals (CI).

RESULTS

The intervention group experienced a significantly lower ankle sprain incidence rate (IRR = 0.26, 95% CI = 0.05, 0.98, p = 0.02) and a tendency toward a lower knee injury incidence rate (IRR = 0.32, 95% CI = 0.03, 1.78, p = 0.07) compared to the control group. Considering only non-contact lower-extremity injuries of any type, the intervention group experienced a significantly lower incidence rate compared to the control group (IRR = 0.26, 95% CI = 0.05, 0.98, p < 0.001).

CONCLUSION

This multi-team study demonstrated a novel multicomponent warm-up program resulted in less lower-extremity injuries, particularly ankle sprains and knee injuries, compared to a typical warm-up program in regional-level male and female basketball players.

The Effects of Modified Game Schedules on Injury Rates in the National Hockey League (NHL)

Background Due to the COVID-19 pandemic, many professional sports leagues such as the National Hockey League (NHL) made significant changes to their schedules and operating procedures. Changes included a modified 2019-2020 playoff format, the removal of the 2020-2021 preseason, and condensed game schedules. Though these modifications were made in an effort to protect players from COVID-19, they resulted in decreased training time and preparation. The purpose of this study was to assess the impact of these changes on the rate of player injuries in the NHL both after the resumption of the midseason stoppage and during the subsequent seasons. Hypothesis/purpose Changes to the NHL schedule amid the COVID-19 pandemic resulted in a significant increase in player injury rates. Methods NHL injuries were obtained from an NHL injury database for the 2018-2019 through the 2021-2022 seasons. The date of injury, date of return, injury description, player age, and player position were recorded. Injury rates were calculated as the number of total athlete injuries per 1000 game exposures (GEs). The primary outcome was the injury proportion ratio (IPR) when comparing the injury rates of the post-COVID-19 season with baseline seasons. Secondary measures analyzed injuries based on age, anatomic location, month in the season, position, length of injury, season-ending injuries, and recurring injuries. Results A total of 4604 injuries were recorded between 2018 and 2022. The modified 2019-2020 playoffs had significantly higher rates of injury (IPR = 1.84, 95% confidence interval {CI} = 1.36-2.49) with more game exposures per week. The 2020-2021 season had significantly higher rates of overall player injury compared to baseline seasons (IPR = 1.19, 95% CI = 1.09-1.30) and also had a higher rate of season-ending injuries (IPR = 1.71, 95% CI = 1.38-2.11). Most injuries occurred in the first few months of the 2020-2021 season. There was no significant difference in injury rate based on age group and no significant difference in the average length of injury between seasons. Conclusion Increases in injury rates could be due to decreased offseason training between seasons, the elimination of preseason games, and increased game density. Decreasing typical training timelines and eliminating the preseason to rapidly return to normal competition after unexpected events (pandemics, lockdowns, etc.) may pose a risk to player safety in the NHL. These findings should be considered before future schedule changes in professional hockey.

Contemporary practices of physical trainers in professional soccer: A qualitative study

Introduction

Physical trainers (PTs) are integral for managing load, reducing injury and optimizing performance in professional soccer. However, little is known about how this practitioners operate in the applied setting and how some of the nuances experienced influence practice.

Methods

This study explored the contemporary practices of PTs in professional soccer. Semi-structured interviews were undertaken with eight PTs from different professional teams in European and South American leagues. Interview questions were designed to extract information on the evaluation of physical abilities, monitoring and control of training and injury prevention. Subsequently, the interviews were video-recorded, transcribed, translated and analyzed using a content analysis approach.

Results

The results suggest that the evaluation of physical capacities is carried out by PTs at the beginning of the preseason. It also appears that it is attempted that this process of regular testing is applied during the competitive period, with most participants conducting partial physiological and physical evaluations at different stages throughout the competitive season. In relation to the monitoring and control of training, subjective feedback scales are used to estimate the internal load, and the use of GPS devices is common to quantify external loads. Injury prevention programmes were implemented by all participants and were generally in a multi-component format focused on preventing or optimizing physical capabilities.

Discussion

These insights can be used as a scientific reference point to inform applied practice in professional soccer, especially for practitioners that are inexperienced and aspiring to enhance how they operate in the field. Future investigations should explore the practices of PTs in detail and across a wider network in order to gain deeper and comprehensive insights into the applied soccer environment.

Well-being as a performance pillar: a holistic approach for monitoring tennis players

This perspective article aims to discuss the usefulness of tools that can assist tennis professionals effectively manage the well-being of their players. This includes identifying and monitoring meaningful metrics (i.e., training load, training intensity, heart rate variability), as well as careful planning of training and competition schedules with appropriate recovery periods. The use of innovative training methods (i.e., repeated-sprint training in hypoxia and heat training), and proper dietary practices, along with biometric assessment for young players, represents should be considered. Adopting a holistic approach to decision-making about training and competition, balancing both health and performance considerations, is crucial for tennis players and their support teams. More research is needed to refine best practices for enhancing tennis performance while prioritizing the well-being of players.

Exercise Cardiac Load and Autonomic Nervous System Recovery during In-Season Training: The Impact on Speed Deterioration in American Football Athletes

Fully restoring autonomic nervous system (ANS) function is paramount for peak sports performance. Training programs failing to provide sufficient recovery, especially during the in-season, may negatively affect performance. This study aimed to evaluate the influence of the physiological workload of collegiate football training on ANS recovery and function during the in-season. Football athletes recruited from a D1 college in the southeastern US were prospectively followed during their 13-week "in-season". Athletes wore armband monitors equipped with ECG and inertial movement capabilities that measured exercise cardiac load (ECL; total heartbeats) and maximum running speed during and baseline heart rate (HR), HR variability (HRV) 24 h post-training. These metrics represented physiological load (ECL = HR·Duration), ANS function, and recovery, respectively. Linear regression models evaluated the associations between ECL, baseline HR, HRV, and maximum running speed. Athletes (n = 30) were 20.2 ± 1.5 years, mostly non-Hispanic Black (80.0%). Negative associations were observed between acute and cumulative exposures of ECLs and running speed (β = -0.11 ± 0.00, p < 0.0000 and β = -0.15 ± 0.04, p < 0.0000, respectively). Similarly, negative associations were found between baseline HR and running speed (β = -0.45 ± 0.12, 95% CI: -0.70, -0.19; p = 0.001). HRV metrics were positively associated with running speed: (SDNN: β = 0.32 ± 0.09, p < 0.03 and rMSSD: β = 0.35 ± 0.11, p < 0.02). Our study demonstrated that exposure to high ECLs, both acutely and cumulatively, may negatively influence maximum running speed, which may manifest in a deteriorating ANS. Further research should continue identifying optimal training: recovery ratios during off-, pre-, and in-season phases.

Effect of the Length of the Microcycle on the Daily External Load, Fatigue, Sleep Quality, Stress, and Muscle Soreness of Professional Soccer Players: A Full-Season Study

BACKGROUND

The aim of this study was to analyze the effect of the length of the microcycle (ie, training period from the day after the match to the following match) on the daily external load and perceived wellness of professional soccer players (Spanish LaLiga Smartbank).

HYPOTHESIS

The length of the microcycle has a significant effect on the daily external load and perceived wellness.

STUDY DESIGN

Longitudinal study.

LEVEL OF EVIDENCE

Level 3.

METHODS

Data were collected daily during a full season using perceived wellness questionnaires and electronic performance and tracking systems.

RESULTS

The length of the microcycle had a significant effect on volume- and intensity-related external load variables. There were differences between short, regular, and long microcycles depending on the day of the microcycle. These differences were observed in all external load variables. However, no significant differences between short, regular, or long microcycles were found on match day for any external load variable, except for high-intensity decelerations. Regarding the perceived wellness, the length of the microcycle had no effect on these variables, and there were no significant interactions between the length and the day of the microcycle.

CONCLUSION

The length of the microcycle had a significant effect on volume- and intensity-related external load variables, but no significant effect on perceived wellness was observed.

CLINICAL RELEVANCE

These data may help strength and conditioning coaches understand that workload periodization should take this contextual variable into account, especially for external training load. In addition, this study may serve as a guide for practitioners to know the physical requirements of professional soccer players in Spanish LaLiga Smartbank, because the weekly external load profile and perceived wellness have been reported for different lengths of the microcycles. Thus, these data may be used for player load management.

A meta-analysis of the criterion-related validity of Session-RPE scales in adolescent athletes

BACKGROUND

The objective of this study was to establish the criterion-related validity of the session-rating of perceived exertion (s-RPE) method in adolescent athletes.

METHODS

According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines, a meta-analysis (PROSPERO ID: CRD42022373126) was performed using Stata 15.1 software. Eight databases using the following terms: ('s-RPE' OR 'Rating Perceived Exertion session' OR 'RPE session' OR 'RPE' OR 'Rate of Perceived Exertion' OR 'Rated of Perceived Exertion') AND ('Adolescen*' OR 'Youth*' OR 'Teen*') AND ('validity' OR 'correlation' OR 'concurrent validity') were searched up to 2022. Articles meeting the inclusion criteria were screened and adopted the "Methodological Index for Non-Randomized Studies (MINORS)" to evaluate the risk of bias.

RESULTS

An initial 1798 studies using the s-RPE method were identified and finally, a total of 16 studies were included for further analysis. The relationship between assessment instruments CR-10 or CR-100 modified methods of s-RPE and the heart rate measures of these selected studies were calculated using correlation coefficient (r values) and Fisher's z-score. A strong to very strong correlation between s-RPE and HR was observed (overall: r = 0.74; CR-10: r = 0.69; CR-100: r = 0.80). CR-100 scale (Fisher's z = 1.09) was shown to have a higher criterion validity than that of the CR-10 scale (Fisher's z = 0.85).

CONCLUSION

Preliminary findings showed that s-RPE using either CR-10 or CR-100 scales can be used "stand-alone" for monitoring internal training load for children and adolescent athletes. Future studies should focus on whether CR-100 could better perform than CR-10 for junior and children athletes in different age groups and sports as well as the causes leading to potential scoring biases.

An Investigation of Surface EMG Shorts-Derived Training Load during Treadmill Running

The purpose of this study was two-fold: (1) to determine the sensitivity of the sEMG shorts-derived training load (sEMG-TL) during different running speeds; and (2) to investigate the relationship between the oxygen consumption, heart rate (HR), rating of perceived exertion (RPE), accelerometry-based PlayerLoadTM (PL), and sEMG-TL during a running maximum oxygen uptake (V˙O2max) test. The study investigated ten healthy participants. On day one, participants performed a three-speed treadmill test at 8, 10, and 12 km·h-1 for 2 min at each speed. On day two, participants performed a V˙O2max test. Analysis of variance found significant differences in sEMG-TL at all three speeds (p < 0.05). A significantly weak positive relationship between sEMG-TL and %V˙O2max (r = 0.31, p < 0.05) was established, while significantly strong relationships for 8 out of 10 participants at the individual level (r = 0.72-0.97, p < 0.05) were found. Meanwhile, the accelerometry PL was not significantly related to %V˙O2max (p > 0.05) and only demonstrated significant correlations in 3 out of 10 participants at the individual level. Therefore, the sEMG shorts-derived training load was sensitive in detecting a work rate difference of at least 2 km·h-1. sEMG-TL may be an acceptable metric for the measurement of internal loads and could potentially be used as a surrogate for oxygen consumption.

The Underlying Mechanisms of Sports Injuries in Paralympic Goalball: A Mixed-Method Study

OBJECTIVE

Data from the Paralympic Games indicate a fluctuating injury incidence in the Paralympic sport goalball, but the mechanisms behind have not been explored. The aims of this study are to (1) quantitatively analyze goalball injuries reported in the London 2012 and Rio 2016 Paralympic Games, (2) qualitatively explain the differences between both games, and (3) qualitatively assess general injury mechanisms and prevention opportunities of injuries in Goalball.

DESIGN

This is a mixed-method study. Injury incidence rates were analyzed from data collected during the 2012 and 2016 Paralympic Games. Then, semistructured interviews of games participants qualitatively explored injury mechanisms and prevention opportunities.

RESULTS

A reduction of injuries occurred from 2012 (incidence rate, 19.5; 95% confidence interval, 12.5-26.5) to 2016 (incidence rate: 5.6; 95% confidence interval, 1.7-9.5). In both games, acute traumatic injuries were most common. Female athletes reported higher rate of injuries compared with males ( P = 0.05). Qualitative data revealed that causes of injuries were collisions, overuse, and poor physical conditioning. The differences between the two games were explained by equipment, environment, and preparations.

CONCLUSIONS

The result from this study indicates that injuries in goalball are multifactorial. Ultimately, the mixed-method data from this study can help the sports context develop prevention measures.

Players', Head Coaches', And Medical Personnels' Knowledge, Understandings and Perceptions of Injuries and Injury Prevention in Elite-Level Women's Football in Ireland

BACKGROUND

To manage injuries effectively, players, head coaches, and medical personnel need to have excellent knowledge, attitudes, and behaviours in relation to the identification of risk factors for injuries, the implementation of injury prevention initiatives, as well as the implementation of effective injury management strategies. Understanding the injury context, whereby specific personal, environmental, and societal factors can influence the implementation of injury prevention initiatives and injury management strategies is critical to player welfare. To date, no qualitative research investigating the context of injuries, has been undertaken in elite-level women's football. The aim of our study was to explore the knowledge, attitudes, and behaviours of players, head coaches, and medical personnel in the Irish Women's National League (WNL) to injury prevention and injury management.

METHODS

We used qualitative research methods to explore the knowledge, attitudes, and behaviours of players, head coaches, and medical personnel in the Irish WNL to injury prevention and injury management. Semi-structured interviews were undertaken with 17 players, 8 medical personnel, and 7 head coaches in the Irish WNL. The data were analysed using thematic analysis. Our study is located within an interpretivist, constructivist research paradigm.

RESULTS

The participants had incomplete knowledge of common injuries in elite-level football, and many held beliefs about risk factors for injuries, such as menstrual cycle stage, which lacked evidence to support them. Jumping and landing exercises were commonly used to reduce the risk of injuries but evidence-based injury prevention exercises and programmes such as the Nordic hamstring curl, Copenhagen adduction exercise, and the FIFA 11+ were rarely mentioned. Overall, there was dissatisfaction amongst players with their medical care and strength and conditioning (S & C) support, with resultant inadequate communication between players, head coaches, and medical personnel.

CONCLUSION

Poor quality and availability of medical care and S & C support were considered to be a major obstacle in the effective implementation of injury risk reduction strategies and successful return-to-sport practices. More original research is required in elite-level women's football to explore injury risk factors, injury prevention initiatives, and contextual return-to-sport strategies, so that players, head coaches, and medical personnel can use evidence that is both up-to-date and specific to their environment.

Clustering U-14 Portuguese regional team football players by lower limb strength, power, dynamic balance, speed and change of direction: understanding the field position factor

Objectives

The aim of this study was to cluster U-14 Portuguese regional team football players based on variables related to lower limb strength and power, dynamic balance, linear sprint, and change of direction.

Method

The sample consisted of 22 young male soccer players (13.83 ± 0.44 years). A set of variables related to lower limb strength and power, dynamic balance, linear sprint, and change of direction was measured.

Results

Overall, a non-significant field position was observed. The countermovement jump (p < 0.001, η² = 0.73), squat jump (p < 0.001), and 30 m linear sprint (p = 0.001) were the main variables responsible for establishing the clusters. Cluster 1 was characterized by a high slalom, i.e., it took longer to complete the test (speed and change of direction) and a low composite score in the dynamic balance. Cluster 2 was characterized by high squat jump, countermovement jump, and reactive strength ratio (lower limb strength and power). Cluster 3 was characterized by low squat jump and countermovement jump (lower limb strength and power), and a high 30 m sprint, i.e., it took longer to complete the test (speed and change of direction). Based on the results of the territorial map, the clusters consisted of: (i) cluster 1: two forwards, one midfielder, and five defenders; (ii) cluster 2: three forwards, two midfielders, and two defenders, and; (iii) cluster 3: four midfielders and three defenders.

Conclusions

Players from different field positions composed the three clusters. There was no cluster composed exclusively of players of the same field position. The development of individualized and specific enrichment training programs should consider a cluster analysis, as the positional effect can be overlooked.

Seasonal changes in physiological and psychological parameters of stress in collegiate swimmers

To investigate the seasonal changes in physiological and psychological parameters of stress in collegiate swimmers. Fifteen NCAA Division I swimmers (8 men) participated in a tethered anaerobic swim test to determine physiological responses in an ecologically-relevant, graded exercise test. Wisconsin Upper Respiratory Symptom Survey (WURSS-21), Activation-Deactivation Adjective Check List (AD-ACL), Daily Analysis of Life Demands of Athletes (DALDA), and Pittsburgh Sleep Quality Index were assessed at post-season in April (V1), the end of off-season in June (V2), and pre-season in October (V3). The percent change was determined from V2-V1 (off-season phase), V3-V2 (pre-season phase), V1-V3 (in-season phase). Spearman's rho correlation was used to examine associations between change in physiological and psychological outcomes. All data results showed a better swim performance occurred at V2. Men tended to have faster speed (p = 0.07) in fewer strokes (p = 0.10) and greater work per stroke (p = 0.10) at V2 than V1. Women were faster during V2 compared to V1 (p = 0.02) and V3 (p = 0.05). Women had fewer strokes (p = 0.02) and greater work per stroke (p = 0.01) at V2 compared to V3. Women had the lowest HR and lactate concentration at V3 compared to other visits (p < 0.05). During the in-season phase, swim speed decreased the greatest extent and stress sources and symptoms assessed by DALDA had greatest elevation (p < 0.05). An increased in stress sources and symptoms assessed by DALDA was associated with an increase in upper respiratory illness from WURSS-21 (rho = 0.44, p = 0.009), being less energetic (rho = - 0.35, p = 0.04) and greater tension state (rho = 0.49, p = 0.003; AD-ACL), and a decrease in swim speed (rho =- 0.38, p = 0.03). Swim performance peaked at off-season when psychological stress was at its lowest. The relationship between DALDA scores with psychological parameters and swim performance suggested physiological and psychological parameters of stress is an important aspect to avoid overtraining when approaching high swim performance.

External Training Load Monitoring and the Impact on Training Load Management in Collegiate Male Soccer Players

ABSTRACT

Gdovin, JR, Galloway, R, Tomasiello, LS, Seabolt, M, and Booker, R. External training load monitoring and the impact on training load management in collegiate male soccer players. J Strength Cond Res 37(7): 1434-1439, 2023-Soccer is a physically demanding sport within the National Collegiate Athletic Association and continuously increases in popularity. To ensure athletes are adequately prepared for weekly physical stressors, coaches can use global positioning system technology to monitor external workloads and exercise intensity. These data can subsequently help coaches and practitioners better implement individualized training programs to ensure athletes are properly balancing the overreaching and overtraining paradigm. Therefore, the purpose of this observational study was to retrospectively analyze 3 consecutive seasons of external workload (total and high intensity distance) and injury data, which were derived from all training sessions and matches in 46 Division-I collegiate male soccer players. A coach's interpretation sought to provide practical insight into the functionality behind load management and how it prepares athletes for the physical stressors placed on them throughout a season. Two separate 3 × 3 repeated measures ANOVAs were conducted to determine differences between total distance and distance at high-intensity with an alpha level set at 0.05. Total distance between preseason and in-season ( p = 0.003), acute high-intensity distance ( p < 0.001), and chronic high-intensity distance ( p < 0.001) yielded significant differences. These results conclude the demands of each athlete change weekly and between seasons. It is recommended that sport coaches and practitioners develop individualized training programs by workload monitoring while considering variables such as a team's style of play, experience, position, role within a program, training intensity, and the length of time between conditioning sessions, practices, and matches.

Blood-Based Biomarkers for Managing Workload in Athletes: Considerations and Recommendations for Evidence-Based Use of Established Biomarkers

Blood-based biomarkers can provide an objective individualized measure of training load, recovery, and health status in order to reduce injury risk and maximize performance. Despite enormous potentials, especially owing to currently evolving technology, such as point-of-care testing, and advantages, in terms of objectivity and non-interference with the training process, there are several pitfalls in the use and interpretation of biomarkers. Confounding variables such as preanalytical conditions, inter-individual differences, or an individual chronic workload can lead to variance in resting levels. In addition, statistical considerations such as the detection of meaningful minimal changes are often neglected. The lack of generally applicable and individual reference levels further complicates the interpretation of level changes and thus load management via biomarkers. Here, the potentials and pitfalls of blood-based biomarkers are described, followed by an overview of established biomarkers currently used to support workload management. Creatine kinase is discussed in terms of its evidence for workload management to illustrate the limited applicability of established markers for workload management to date. We conclude with recommendations for best practices in the use and interpretation of biomarkers in a sport-specific context.

Return to sport in elite gymnastics: Unprecedented training interruptions provide lessons for the future

INTRODUCTION

Year-round training is standard for elite gymnasts in the United States, but the coronavirus disease 2019 (COVID-19) pandemic led to unprecedented training interruptions. The effect of these training disruptions is unknown.

OBJECTIVE

This study aimed to describe and compare training interruptions in elite gymnasts before and during the pandemic, the time it took to return to the prior level of gymnastics training, the development of injuries during return to gymnastics training, and gymnast-reported difficulty in and nervousness about returning to prior level of gymnastics training.

DESIGN

Retrospective study.

SETTING

Anonymous online surveys distributed to elite gymnasts in the United States.

PARTICIPANTS

A total of 184 current elite gymnasts who completed the surveys were included. This represented an overall response rate of 52.3% (184/352).

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Information was collected about training interruptions and time, nervousness, difficulty, and injury during return to gymnastics.

RESULTS

Gymnasts reported significantly longer training interruptions due to COVID-19 than before the pandemic (8.7 ± 4.4 vs. 4.4 ± 7.9 weeks, p < .001), but duration of return to prior gymnastics level was similar (4.6 ± 2.7 vs. 3.7 ± 4.8 weeks, p = .106). Of the 137 gymnasts who had returned to training by the time of the survey, 46 (33.6%) reported an injury during their return to gymnastics. A high degree of nervousness to return to gymnastics was significantly associated with greater risks of injury upon return (risk ratio [RR] 2.7, 95% confidence interval [CI]: 1.6-4.7; p < .001) and difficulty returning to prior level (RR 3.4, 95% CI: 1.7-6.6; p < .001).

CONCLUSION

Pandemic-related training interruption was significantly greater in duration than prior interruptions, but time required for return to gymnastics was similar. Gymnasts may be at increased risk of injury during return to gymnastics if experiencing nervousness about returning following a break in training. These findings provide guidance for gymnasts' return from training interruptions and may refute the long-held belief that gymnasts should not take time away from training due to fear of injury or difficulty regaining skills.

Association between internal training load and muscle injuries in Brazilian professional soccer players

The training load is associated with injury risk in a variety of sports. This study aimed to evaluate the association between the internal training load and injury risk in Brazilian professional soccer players. The data were collected from 32 soccer players across two full seasons (2017 and 2018). The rating of perceived exertion (RPE) for every training/match session was used as an internal load variable. The cumulative training load from 3 and 4 weeks (C3 and C4) and the acute:chronic workload ratio (ACWR) were calculated. A generalized estimating equation analysis was applied to examine associations of non-contact muscle injuries with C3, C4 and ACWR. A total of 33 injuries were recorded across the two full seasons. A significant association was found between cumulative training load for three (C3, p = 0.003) and four weeks (C4, p = 0.023) and the occurrence of injuries. Players in the "high load" group presented greater injury risk in relation to the "moderate load" group (C4: OR = 4.5; IC 95% 1.5-13.3; C3: OR = 3.7; IC 95% 1.7-8.1). There was no association between ACWR and injury occurrence. The athletes exposed to a high cumulative load in a period of 3 to 4 weeks presented higher injury risk in comparison to those who had moderate cumulative training loads. Besides that, there was no association between ACWR and injury occurrence.

Effect of core training on athletic and skill performance of basketball players: A systematic review

A limited number of studies focus on the effect of core training on basketball players' athletic performance and skills. This systematic reviewaimed to comprehensively and critically review the available studies in the literature that investigate the impact of core training on basketball players' physical and skill performance, and then offer valuable recommendations for both coaches and researchers. Thedata collection, selection, and analysis adhered to the PRISMA protocol. English databases, including Ebscohost, Scopus, PubMed, Web of Science, and Google Scholar,were searched until September 2022. A total of eight articles were included, with four studies comparing the effects of core training versus traditional strength training or usual basketball training. All studies investigated the impact of core training on athletic performance. The findings revealed that core training can help players improve their overall athletic and skill performance, particularly in the areas of strength, sprinting,jumping, balance, agility, shooting, dribbling, passing, rebounding, and stepping. In addition, core training, particularly on unstable surfaces,as well as combining static and dynamic core training,improvebasketball players' athletic and skill performance. Despite the relativelylittle evidence demonstrating the effect of core training on endurance, flexibility, and defensive skills, this review demonstrates that it should be incorporated into basketball training sessions.

Irish Dancing Injuries and Associated Risk Factors: A Systematic Review

Irish dance is growing in popularity, evolving to a more athletic and demanding dance style. The aim of this study is to conduct a systematic review, previously registered with PROSPERO, to identify the prevalence, incidence, and the injury pattern among Irish dancers and analyse the associated risk factors. Six online databases and two dance-specific science publications were searched systematically. Studies were included if the patterns of injuries among Irish dancers were evaluated or the factors associated with injury were analysed, published in English or Portuguese, in peer-reviewed scientific journals. Four reviewers assessed the quality and level of evidence using the Downs and Black criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Eleven articles were included, eight of Level 3c (cross-sectional) and three of Level 3b (prospective). Mean DB percentage score was 63% ± 7.2%. Prevalence ranged from 72.2% to 92.6%, affecting mostly the foot/ankle complex. Only two articles reported incidence, which ranged from 3.4 to 10.6 injuries/1000 h danced depending on injury definition. Psychological factors, elite level, and insufficient/poor sleep were associated with musculoskeletal injury. Injury prevalence and incidence is high in Irish dancers, with the foot and ankle being more affected. Due to heterogeneity in injury definitions, methods, and populations, along with the need for improvement in studies quality, recommendations were made for future research.

Externally validated machine learning algorithm accurately predicts medial tibial stress syndrome in military trainees: a multicohort study

Objectives

Medial tibial stress syndrome (MTSS) is a common musculoskeletal injury in both sporting and military settings. No reliable treatments exist, and reoccurrence rates are high. Prevention of MTSS is critical to reducing operational burden. Therefore, this study aimed to build a decision-making model to predict the individual risk of MTSS within officer cadets and test the external validity of the model on a separate military population.

Design

Prospective cohort study.

Methods

This study collected a suite of key variables previously established for predicting MTSS. Data were obtained from 107 cadets (34 women and 73 men). A follow-up survey was conducted at 3 months to determine MTSS diagnoses. Six ensemble learning algorithms were deployed and trained five times on random stratified samples of 75% of the dataset. The resultant algorithms were tested on the remaining 25% of the dataset, with models then compared for accuracy. The most accurate new algorithm was tested on an unrelated data sample of 123 Australian Navy recruits to establish external validity of the model.

Results

Calibrated random forest modelling was the most accurate in identifying a diagnosis of MTSS; (area under curve (AUC)=98%, classification accuracy (CA)=96%). External validation on a sample of Navy recruits resulted in comparable accuracy; (AUC=95%, CA=94%). When the model was tested on the combined datasets, similar accuracy was achieved; (AUC=92%, CA=91%).

Conclusion

This model is highly accurate in predicting those who will develop MTSS. The model provides important preventive capacity which should be trialled as a risk management intervention.

Accumulated Workload Differences in Collegiate Women's Soccer: Starters versus Substitutes

The purpose of this study was to estimate the workloads accumulated by collegiate female soccer players during a competitive season and to compare the workloads of starters and substitutes. Data from 19 college soccer players (height: 1.58 ± 0.06 m; body mass: 61.57 ± 6.88 kg) were extracted from global positioning system (GPS)/heart rate (HR) monitoring sensors to quantify workload throughout the 2019 competitive season. Total distance, distance covered in four speed zones, accelerations, and time spent in five HR zones were examined as accumulated values for training sessions, matches, and the entire season. Repeated-measures ANOVA and Student's t tests were used to determine the level of differences between starter and substitute workloads. Seasonal accumulated total distance (p < 0.001), sprints (≥19.00 km/h; p < 0.001), and high-speed distance (≥15.00 km/h; p = 0.005) were significantly greater for starters than substitutes. Accumulated training load (p = 0.08) and training load per minute played in matches (p = 0.08) did not differ between starters and substitutes. Substitutes had similar accumulated workload profiles during training sessions but differed in matches from starters. Coaches and practitioners should pursue strategies to monitor the differences in workload between starters and substitutes.

The effect of progressive and individualised sport-specific training on the prevalence of injury in football and handball student athletes: a randomised controlled trial

Objective

To evaluate the effectiveness of communication and coordination combined with designing a progressive and individualised sport-specific training program for reducing injury prevalence in youth female and male football and handball players transitioning to a sports academy high school. An additional aim was to investigate the characteristics of the reported injuries.

Methods

Forty-two Norwegian athletes were randomised into an intervention or control group. Mean age, height, weight and BMI was 15.5 ± 0.5 years, 178.6 cm ± 6.3 cm, 71.3 ± 9.8 kg, 22.3 ± 2.7 BMI for the intervention group (IG) (n = 23), and 15.4 ± 0.5 years, 175.6 cm ± 6.6 cm, 67.1 ± 9.8 kg, 21.7 ± 2.4 BMI for the control group (CG) (n = 19). During the summer holiday, the intervention group received weekly progressive, individualised sport-specific training programs and weekly follow-up telephone calls from the researchers. All athletes completed a baseline questionnaire and a physical test battery. Training data and injuries were recorded prospectively for 22 weeks using the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2). A two-way chi-square (χ²) test of independence was conducted to examine the relationship between groups and injury.

Results

Average weekly prevalence of all injuries was 11% (95% CI: 8%-14%) in IG and 19% (95% CI: 13%-26%) in CG. Average weekly prevalence of substantial injuries was 7% (95% CI: 3%-10%) in IG and 10% (95% CI: 6%-13%) in CG. The between-group difference in injuries was significant: χ² (1, N = 375) = 4.865, p = .031, φ = .114, with 1.8 times higher injury risk in CG vs. IG during the first 12 weeks after enrolment.

Conclusions

For student athletes transitioning to a sports academy high school, progressive individualised, sport-specific training programs reduced the prevalence of all-complaint injuries following enrolment. Clubs and schools should prioritise time and resources to implement similar interventions in periods where student athletes have less supervision, such as the summer holidays, to facilitate an optimal transition to a sports academy high school.